Abstract
Diabetes has been associated with cognitive changes and an increased risk of vascular dementia and Alzheimer’s disease, but it is unclear whether there are associations between diabetes and early alterations in cognitive performance. The present study consisted of a cross-section analysis of 14,444 participants aged 35–74 years and from a developing country at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA–Brasil); these participants were recruited between 2008 and 2010. We investigated whether there was an association between diabetes and early changes in the cognitive performance of this Brazilian population. To assess cognitive domains, we used the word-list learning, word-list delayed recall and word recognition tests along. Phonemic verbal fluency tests included semantic phonemic test (animals) and a phonemic test (words beginning with the letter F). Executive functions associated with attention, concentration and psychomotor speed were evaluated using the Trail Making Test B. The exposure variable in the study was defined as diabetes. Multiple linear regression was used to estimate the association between diabetes and cognitive performance. The results were adjusted for age, sex, education, hypertension, coronary disease, depression, physical activity, smoking, alcohol consumption, and the cholesterol/HDL-C ratio. We found a significant association between diabetes and decreased memory, language and executive function (attention, concentration and psychomotor speed) performance in this population from a country with a distinct epidemiological profile, even after adjusting for the main intervening variables.
Highlights
The world population is ageing, and the incidence of neurodegenerative diseases associated with age is increasing
There was an association between a worse cognitive performance in all cognitive tests and the highest age group, decreased schooling and smoking
We found that a lower cognitive performance was associated with diabetes
Summary
The world population is ageing, and the incidence of neurodegenerative diseases associated with age is increasing. A systematic review that included case-control and population-based studies showed that the risk of overall cognitive dysfunction was increased in people with diabetes in five of seven cohorts. To Berg et al, the association between diabetes and cognition differed among the domains; the processing speed was significantly affected in 63% of the studies; attention, in 50%; memory, in 44%; cognitive flexibility, in 38%; one language, 33% and general intelligence in 31%11. These functions are relevant because they involve behaviours such as problem solving, judgement, and changing habits. The relevance of this study deserves to be highlighted; this is a Latin American cohort, and there are increasing incidence rates of diabetes and cognitive impairment in middle and low-income countries[14]
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